FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

LESLIE WOODS,

Plaintiff-Appellant,

v.

KILOLO KIJAKAZI, Acting 

Commissioner of Social Security,

Defendant-Appellee.

No. 21-35458

D.C. No.

3:20-cv-00805-

BR

OPINION

Appeal from the United States District Court

for the District of Oregon

Anna J. Brown, District Judge, Presiding

Submitted March 8, 2022*

Seattle, Washington

Filed April 22, 2022

Before: Jacqueline H. Nguyen, Eric D. Miller, and

Patrick J. Bumatay, Circuit Judges.

Opinion by Judge Nguyen

* The panel unanimously concludes this case is suitable for decision 

without oral argument. See Fed. R. App. P. 34(a)(2).
2 WOODS V. KIJAKAZI

SUMMARY**

Social Security

The panel affirmed the district court’s decision affirming 

the Commissioner of Social Security’s denial of claimant’s 

application for benefits under the Social Security Act based 

on various physical and mental impairments.

As a threshold matter, the panel held that recent changes 

to the Social Security Administration’s regulations displaced 

longstanding case law requiring an administrative law judge 

(“ALJ”) to provide “specific and legitimate” reasons for 

rejecting an examining doctor’s opinion. For claims filed on 

or after March 27, 2017, that are subject to the new 

regulations, the former hierarchy of medical opinions – in 

which the court assigned presumptive weight based on the 

extent of the doctor’s relationship with the claimant – no 

longer applies. While the panel agreed with the government 

that the “specific and legitimate” standard was clearly 

irreconcilable with the 2017 regulations, the panel held that 

the extent of the claimant’s relationship with the medical 

provider – the “relationship factors” – remained relevant 

under the new regulations. An ALJ can still consider the 

length and purpose of the treatment relationship, the 

frequency of examinations, the kinds and extent of 

examinations that the medical source has performed or 

ordered from specialists, and whether the medical source has 

examined the claimant or merely reviewed the claimant’s 

records. However, the ALJ no longer needs to make specific 

findings regarding those relationship factors. Even under the 

** This summary constitutes no part of the opinion of the court. It 

has been prepared by court staff for the convenience of the reader.
WOODS V. KIJAKAZI 3

new regulations, an ALJ cannot reject an examining or 

treating doctor’s opinion as unsupported or inconsistent 

without providing an explanation supported by substantial 

evidence.

Here, the ALJ acknowledged Dr. Causeya’s opinion that 

the claimant had marked and extreme limitations in various 

cognitive areas, including memory and concentration; but 

the ALJ found this opinion unpersuasive because it was 

inconsistent with the overall treating notes and mental status 

exams in the record. The panel held that substantial 

evidence supported the ALJ’s inconsistency finding. 

The panel rejected claimant’s contention that the ALJ 

failed to consider all her physical and mental limitations that 

are supported by the record. Because substantial evidence 

supported the ALJ’s decision here, the panel affirmed.

COUNSEL

George Joseph Wall, Law Offices of George J. Wall, 

Portland, Oregon, for Plaintiff-Appellant.

Willy Le, Acting Regional Chief Counsel, Seattle Region X; 

Jeffrey E. Staples, Assistant Regional Counsel; Office of 

General Counsel, Social Security Administration, Seattle, 

Washington; Scott Erik Asphaug, United States Attorney; 

Renata Gowie, Civil Division Chief; United States 

Attorney’s Office, Portland, Oregon; for DefendantAppellee.
4 WOODS V. KIJAKAZI

OPINION

NGUYEN, Circuit Judge:

Leslie Woods seeks benefits under the Social Security 

Act based on various physical and mental impairments. An 

administrative law judge (“ALJ”) found that she was not 

disabled and denied her claim. The district court affirmed.

As a threshold matter, we must decide whether recent 

changes to the Social Security Administration’s regulations 

displace our longstanding case law requiring an ALJ to 

provide “specific and legitimate” reasons for rejecting an 

examining doctor’s opinion. We conclude that they do. For 

claims subject to the new regulations, the former hierarchy 

of medical opinions—in which we assign presumptive 

weight based on the extent of the doctor’s relationship with 

the claimant—no longer applies. Now, an ALJ’s decision, 

including the decision to discredit any medical opinion, must 

simply be supported by substantial evidence. Because 

substantial evidence supports the ALJ’s decision here, we 

affirm.

I.

Woods applied for disability insurance benefits and 

supplemental security income in July 2017. See 42 U.S.C. 

§§ 423, 1381a, 1395i-2a. The agency denied her claim 

initially and on reconsideration. Following a hearing on 

Woods’s administrative appeal, the ALJ determined that she 

was not disabled.
WOODS V. KIJAKAZI 5

At step two of the analysis,1 the ALJ concluded that 

Woods had two severe impairments: cervical degenerative 

disc disease and osteoarthritis involving the hip and knees. 

The ALJ concluded that Woods’s other reported 

impairments—including small fiber neuropathy, anterior 

tibialis tendonitis of the right leg, venous insufficiency, 

carpal tunnel syndrome, obesity, hypertension, depression, 

and anxiety—were not severe. In reaching this conclusion, 

the ALJ rejected the opinion of Dr. Karla Rae Causeya, a 

psychologist who examined Woods and assessed her ability 

to work. Dr. Causeya evaluated Woods to have “marked and 

extreme limitations in a number of areas of understanding, 

remembering or applying information, interacting with 

1 The recent changes to the Social Security regulations did not affect 

the familiar “five-step sequential evaluation process.” 20 C.F.R. 

§ 404.1520(a)(1) (disability insurance benefits); see also id.

§ 416.920(a)(4) (same standard for supplemental security income). This 

process ends when the ALJ can make a finding that the claimant is or is 

not disabled. Id. § 404.1520(a)(4). At the first step, a claimant “doing 

substantial gainful [work] activity” is not disabled. Id.

§ 404.1520(a)(4)(i). At the second step, a claimant is not disabled unless 

she has a “medically determinable physical or mental impairment” or 

combination of impairments that is severe and either lasts at least a year 

or can be expected to result in death. Id. § 404.1520(a)(4)(ii); see also

42 U.S.C. §§ 423(d)(1), 1382c(a)(3)(C)(i). At the third step, a claimant 

is disabled if the severity of her impairments meets or equals one of 

various impairments listed by the Commissioner of Social Security, 

20 C.F.R. pt. 404, subpt. P, app. 1. See 20 C.F.R. § 404.1520(a)(4)(iii). 

At the fourth step, a claimant is not disabled if her residual functional 

capacity allows her to perform her past relevant work. Id.

§ 404.1520(a)(4)(iv). At the fifth step, a claimant is disabled if, given 

her residual functional capacity, age, education, and work experience,

she cannot make an adjustment to other work that “exists in significant 

numbers in the national economy,” id. § 404.1560(c)(2). See id.

§ 404.1520(a)(4)(v).
6 WOODS V. KIJAKAZI

others, concentrating, persisting and maintaining pace, and 

adaptation.”

At step four of the analysis, the ALJ concluded that 

Woods had the residual functional capacity to perform “light 

work” with minor limitations. Based on this finding, the 

ALJ found that Woods could perform her past relevant work 

as a cosmetologist and hairstylist.

The Appeals Council denied review of the ALJ’s 

decision. Woods then sought judicial review. The district 

court, reviewing the ALJ’s decision, affirmed the agency’s 

denial of benefits.

II.

We have jurisdiction under 28 U.S.C. § 1291. We 

review the district court’s order affirming the ALJ’s denial 

of social security benefits de novo, and we will not overturn 

the Commissioner’s decision “unless it is either not 

supported by substantial evidence or is based upon legal 

error.” Luther v. Berryhill, 891 F.3d 872, 875 (9th Cir. 

2018). Under the substantial-evidence standard, we look to 

the existing administrative record and ask “whether it 

contains ‘sufficient evidence’ to support the agency’s factual 

determinations.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 

(2019) (cleaned up) (quoting Consol. Edison Co. of N.Y. v. 

NLRB, 305 U.S. 197, 229 (1938)). “Substantial” means 

“more than a mere scintilla” but only “such relevant 

evidence as a reasonable mind might accept as adequate to 

support a conclusion.” Id. (quoting Consol. Edison, 

305 U.S. at 229). “Where evidence is susceptible to more 

than one rational interpretation, it is the ALJ’s conclusion 

that must be upheld.” Burch v. Barnhart, 400 F.3d 676, 679 

(9th Cir. 2005).
WOODS V. KIJAKAZI 7

III.

Woods contends that the ALJ improperly rejected the 

opinion of her examining physician, Dr. Causeya, that she 

has memory and concentration impairments. The ALJ found 

that Dr. Causeya’s opinion conflicted with evidence from 

other medical sources. But before turning to the merits of 

this claim, we must first resolve the parties’ dispute over the 

applicable legal standard.

Woods argues that the ALJ erred in rejecting 

Dr. Causeya’s opinion by failing to provide “specific and 

legitimate reasons that are supported by substantial evidence 

in the record.” Lester v. Chater, 81 F.3d 821, 830–31 (9th 

Cir. 1996). The government counters that changes to the 

Social Security regulations in 2017 “eliminate any 

semblance of a hierarchy of medical opinions and state that 

the agency does not defer to any medical opinions, even 

those from treating sources.” We agree with the 

government.

A.

For nearly 40 years, we have weighed medical opinions 

based on the extent of the doctor’s relationship with the 

claimant.2 We categorized these relationships in a three2 Although we refer to doctors for convenience, our discussion 

applies to evidence from any “acceptable medical source,” which 

includes medical professionals other than physicians, such as 

psychologists and certain advanced practice nurses and physician 

assistants. See 20 C.F.R. § 404.1502(a)(2), (7), (8); see also id.

§ 404.1527(a)(1) (former regulation defining “medical opinions” as 

“statements from acceptable medical sources that reflect judgments 

about the nature and severity of [a claimant’s] impairment(s)”); id.

§ 404.1521 (current regulation requiring “objective medical evidence 

from an acceptable medical source”).
8 WOODS V. KIJAKAZI

tiered hierarchy. See Smith v. Kijakazi, 14 F.4th 1108, 1114 

(9th Cir. 2021). At the top are treating physicians. These 

medical sources treat or evaluate the claimant and have an 

ongoing treatment relationship with her. See 20 C.F.R. 

§ 404.1527(a)(2); Benton ex rel. Benton v. Barnhart, 

331 F.3d 1030, 1036–38 (9th Cir. 2003).

A treating physician’s opinion is entitled to “substantial 

weight,” Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020) 

(quoting Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 

1988)), and we generally give it “more weight . . . than . . . 

the opinion of doctors who do not treat the claimant,” Lester, 

81 F.3d at 830. This deference “is based not only on the fact 

that [a treating physician] is employed to cure but also on 

[the physician’s] greater opportunity to observe and know 

the patient as an individual.” Murray v. Heckler, 722 F.2d 

499, 502 (9th Cir. 1983) (quoting Bowman v. Heckler, 

706 F.2d 564, 568 (5th Cir. 1983)); see also 20 C.F.R. 

§ 404.1527(c)(2) (“[Y]our treating sources . . . are likely to 

be the medical professionals most able to provide a detailed, 

longitudinal picture of your medical impairment(s) and may 

bring a unique perspective to the medical evidence that 

cannot be obtained from the objective medical findings alone 

or from reports of individual examinations . . . .”).

In the middle tier are doctors who examine the claimant 

but do not have an ongoing relationship with her. “The 

opinion of an examining physician is . . . entitled to greater 

weight than the opinion of a nonexamining physician.” 

Ford, 950 F.3d at 1155 (quoting Lester, 81 F.3d at 830); see

20 C.F.R. § 404.1527(c)(1).

To reject either a treating or an examining physician’s 

opinion, an ALJ must provide “clear and convincing 

reasons,” if the opinion is uncontradicted by other evidence, 

or “specific and legitimate reasons” otherwise, and the 
WOODS V. KIJAKAZI 9

reasons must be supported by substantial evidence. Revels 

v. Berryhill, 874 F.3d 648, 654 (9th Cir. 2017) (quoting Ryan 

v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 

2008)).

The lowest-weighted tier comprises “physicians who 

only review the record.” Benton, 331 F.3d at 1036. “The 

opinion of a nonexamining physician cannot by itself 

constitute substantial evidence that justifies the rejection of 

the opinion of either an examining physician or a treating 

physician.” Lester, 81 F.3d at 831.

B.

The new regulations apply to Woods because she filed 

her claim on or after March 27, 2017. See Revisions to Rules 

Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 

5844, 5844 (Jan. 18, 2017) (codified at 20 C.F.R. pts. 404 & 

416). We must therefore decide whether, as Woods argues, 

“the ‘specific and legitimate’ standard still applies under the 

new rules.”

Our precedent controls unless its “reasoning or theory

. . . is clearly irreconcilable with the reasoning or theory of 

intervening higher authority,” which in this case is the 

agency’s updated regulations. Lambert v. Saul, 980 F.3d 

1266, 1274 (9th Cir. 2020) (quoting Miller v. Gammie, 

335 F.3d 889, 893 (9th Cir. 2003) (en banc)). While we 

agree with the government that the “specific and legitimate” 

standard is clearly irreconcilable with the 2017 regulations, 

the extent of the claimant’s relationship with the medical 

provider—what we will refer to as “relationship factors”—

remains relevant under the new regulations.
10 WOODS V. KIJAKAZI

1.

The Social Security Act provides no guidance as to how 

the agency should evaluate medical evidence. It merely 

directs the Commissioner of Social Security “to make 

findings of fact” and discuss “the evidence . . . and the 

reason or reasons upon which [any unfavorable decision] is 

based.” 42 U.S.C. §§ 405(b)(1), 1383(c)(1)(A). And it 

provides that the Commissioner’s “findings. . . as to any fact

. . . shall be conclusive” on judicial review “if supported by 

substantial evidence.” Id. § 405(g).

The Commissioner has wide latitude “to make rules and 

regulations and to establish procedures . . . to carry out [the 

statutory] provisions,” in particular regulations governing 

“the nature and extent of the proofs and evidence . . . to 

establish the right to benefits.” Id. § 405(a); see Bowen v. 

Yuckert, 482 U.S. 137, 145 (1987) (observing that the 

agency has “exceptionally broad authority” to promulgate 

evidentiary rules, which therefore may be set aside only if 

they exceed the agency’s statutory authority or are arbitrary 

and capricious).3 The statute directs the claimant to furnish 

whatever “medical and other evidence of [disability]” the 

Commissioner “may require,” and it directs the 

Commissioner to consider “[o]bjective medical evidence of 

3 In this case, the issue is one of adherence to our own precedent 

rather than deference to the agency. Woods does not argue that the 2017 

regulations exceed the agency’s statutory authority or are arbitrary and 

capricious. See Yuckert, 482 U.S. at 145. Whether our caselaw is clearly 

irreconcilable with the 2017 regulations is not a question entrusted to the 

agency’s expertise. See Acosta v. Gonzales, 439 F.3d 550, 553 n.4 (9th 

Cir. 2006) (“[A]n agency is not owed deference when the issue is the 

interpretation of Circuit law rather than the statute.”), overruled on other 

grounds by Garfias-Rodriguez v. Holder, 702 F.3d 504, 514 (9th Cir. 

2012) (en banc).
WOODS V. KIJAKAZI 11

pain or other symptoms established by medically acceptable 

clinical or laboratory techniques.” 42 U.S.C. 

§ 423(d)(5)(A). Beyond that, how to evaluate the evidence 

is up to the agency.

The agency formalized the prior rule emphasizing 

relationship factors in 1991, see Standards for Consultative 

Examinations and Existing Medical Evidence, 56 Fed. Reg. 

36,932 (Aug. 1, 1991), but the rule’s genesis was a series of 

court decisions. See id. at 36,934 (“[T]he majority of the 

circuit courts generally agree on two basic principles. First

. . . [,] treating source evidence tends to have a special 

intrinsic value . . . . Second . . . [,] if the [Commissioner] 

decides to reject such an opinion, he should provide the 

claimant with good reasons for doing so. We have been 

guided by these principles in our development of the final 

rule.”); see also Revisions to Rules Regarding the 

Evaluation of Medical Evidence, 81 Fed. Reg. 62,560, 

62,572 (Sept. 9, 2016) (explaining that the agency 

promulgated the 1991 rule “to create a uniform national 

policy about how to consider medical opinions from treating 

physicians”).

One of those decisions was Murray, where we joined the 

Second, Fifth, and Sixth Circuits “in giving greater weight 

to the opinions of treating physicians.” Murray, 722 F.2d 

at 501 (citing Bowman, 706 F.2d at 568 & n.3; Allen v. 

Califano, 613 F.2d 139, 145 (6th Cir. 1980); McLaughlin v. 

Sec’y of Health, Educ. & Welfare, 612 F.2d 701, 705 (2d Cir. 

1980)). In accordance with that principle, Murry established 

the “specific and legitimate” standard: “If the ALJ wishes to 

disregard the opinion of the treating physician, he or she 

must make findings setting forth specific, legitimate reasons 

for doing so that are based on substantial evidence in the 

record.” Id. at 502.
12 WOODS V. KIJAKAZI

Under the 1991 rule, an ALJ gives “more weight to the 

medical opinion of a source who has examined [the 

claimant] than to the medical opinion of a medical source 

who has not examined [her].” 20 C.F.R. § 404.1527(c)(1). 

In addition, the ALJ gives “more weight to medical opinions 

from [the claimant’s] treating sources, since these sources 

are likely to be the medical professionals most able to 

provide a detailed, longitudinal picture of [her] medical 

impairment(s).” Id. § 404.1527(c)(2).

2.

The agency revised the rules for evaluating medical 

evidence in 2017 to resolve several “adjudicative issues.” 

Revisions to Rules Regarding the Evaluation of Medical 

Evidence, 81 Fed. Reg. at 62,572. To begin with, ALJs often 

needed “to make a large number of findings” to avoid a 

remand for “failure to weigh properly one of the many 

medical opinions in a record.” Id. Courts sometimes 

“focused more on whether [the agency] sufficiently 

articulated the weight [it] gave treating source opinions 

rather than on whether substantial evidence supports the 

Commissioner’s final decision.” Id. The agency also had 

concerns that “the treating physician rule’s built-in 

evidentiary bias in favor of treating physicians may 

influence treating sources to favor a finding of disabled.” Id.

at 62,572–73 (citing Black & Decker Disability Plan v. 

Nord, 538 U.S. 822, 832 (2003)).

In addition, the agency disagreed with our practice of 

“combin[ing] the treating physician rule with [our] credit-astrue rule” whereby we sometimes remanded with an order to 

award benefits if the ALJ provided insufficient reasons for 

rejecting a treating source opinion. Id. at 62,573. This 

practice “prevent[ed] [the agency] from reconsidering the 
WOODS V. KIJAKAZI 13

evidence in the record as a whole and correcting any errors.” 

Id.

Lastly, the agency expressed doubts about “the 

presumption that a claimant’s sole treating physician 

generally has the longitudinal knowledge and a unique 

perspective about his or her patient’s impairments that 

objective medical evidence alone cannot provide.” Id. The 

agency found this presumption “less persuasive” than it had 

been 25 years earlier due to “changes in the national 

healthcare workforce and in the manner in which many 

people now receive primary medical care.” Id.

Under the revised regulations, “there is not an inherent 

persuasiveness to evidence from [government consultants] 

over [a claimant’s] own medical source(s), and vice versa.” 

Revisions to Rules Regarding the Evaluation of Medical 

Evidence, 82 Fed. Reg. at 5844. “The most important 

factors” that the agency considers when evaluating the 

persuasiveness of medical opinions are “supportability” and 

“consistency.” 20 C.F.R. § 404.1520c(a). Supportability 

means the extent to which a medical source supports the 

medical opinion by explaining the “relevant . . . objective 

medical evidence.” Id. § 404.1520c(c)(1). Consistency 

means the extent to which a medical opinion is “consistent

. . . with the evidence from other medical sources and 

nonmedical sources in the claim.” Id. § 404.1520c(c)(2).

The revised regulations recognize that a medical 

source’s relationship with the claimant is still relevant when 

assessing the persuasiveness of the source’s opinion. See id.

§ 404.1520c(c)(3). Thus, an ALJ can still consider the 

length and purpose of the treatment relationship, the 

frequency of examinations, the kinds and extent of 

examinations that the medical source has performed or 

ordered from specialists, and whether the medical source has 
14 WOODS V. KIJAKAZI

examined the claimant or merely reviewed the claimant’s 

records. Id. § 404.1520c(c)(3)(i)–(v). However, the ALJ no 

longer needs to make specific findings regarding these 

relationship factors:

[W]e will explain how we considered the 

supportability and consistency factors for a 

medical source’s medical opinions . . . in 

your determination or decision. We may, but 

are not required to, explain how we 

considered the [relationship] factors . . . 

when we articulate how we consider medical 

opinions . . . in your case record.

Id. § 404.1520c(b)(2) (emphasis added).

A discussion of relationship factors may be appropriate 

when “two or more medical opinions . . . about the same 

issue are . . . equally well-supported . . . and consistent with 

the record . . . but are not exactly the same.” Id.

§ 404.1520c(b)(3). In that case, the ALJ “will articulate how 

[the agency] considered the other most persuasive factors.” 

Id. Other factors include relationship factors, id.

§ 404.1520c(c)(3), whether the medical source’s opinion 

concerns “medical issues related to his or her area of 

specialty,” id. § 404.1520c(c)(4), and any “other factors that 

tend to support or contradict [the] medical opinion,” id.

§ 404.1520c(c)(5).

3.

The revised social security regulations are clearly 

irreconcilable with our caselaw according special deference 

to the opinions of treating and examining physicians on 

account of their relationship with the claimant. See

20 C.F.R. § 404.1520c(a) (“We will not defer or give any 
WOODS V. KIJAKAZI 15

specific evidentiary weight, including controlling weight, to

any medical opinion(s) . . . , including those from your 

medical sources.”). Our requirement that ALJs provide 

“specific and legitimate reasons” for rejecting a treating or 

examining doctor’s opinion, which stems from the special 

weight given to such opinions, see Murray, 722 F.2d at 501–

02, is likewise incompatible with the revised regulations. 

Insisting that ALJs provide a more robust explanation when 

discrediting evidence from certain sources necessarily 

favors the evidence from those sources—contrary to the 

revised regulations.

Even under the new regulations, an ALJ cannot reject an 

examining or treating doctor’s opinion as unsupported or 

inconsistent without providing an explanation supported by 

substantial evidence. The agency must “articulate . . . how 

persuasive” it finds “all of the medical opinions” from each 

doctor or other source, 20 C.F.R. § 404.1520c(b), and 

“explain how [it] considered the supportability and 

consistency factors” in reaching these findings, id.

§ 404.1520c(b)(2).

C.

Here, the ALJ acknowledged Dr. Causeya’s opinion that 

Woods has marked and extreme limitations in various 

cognitive areas, including memory and concentration. The 

ALJ found this opinion unpersuasive because it was 

inconsistent with the overall treating notes and mental status 

exams in the record.4 Substantial evidence supports the 

ALJ’s inconsistency finding.

4 The ALJ described Dr. Causeya’s opinion as “not supported by” 

the record, but the ALJ plainly did not intend to make a supportability 
16 WOODS V. KIJAKAZI

The ALJ pointed to Dr. Mischelle McMillan’s February 

2018 observation that Woods’s “[c]ognition and memory are 

normal.” The ALJ also noted the inconsistency between Dr. 

Causeya’s opinion that Woods cannot obtain or maintain 

gainful employment and “the fact that [Woods’s] income has 

not significantly declined since her alleged onset date” 

despite her having “the additional duties of caring for . . . a 

[13-year-old] and dealing with her [80-year-old] mother’s 

medical issues.”

The evidence on which Woods relies does not show that 

she has severe difficulties in attention, concentration, or 

memory. For example, on five occasions in 2018, Nurse 

Practitioner Anne Pollock assessed Woods to have good or 

fair attention and concentration and normal memory.

Most of the psychological evidence that Woods cites is 

treatment notes from Licensed Professional Counselor Heidi 

Bermeosolo. These treatment notes do not discuss Woods’s 

attention, concentration, or memory at all. Rather, they 

concern, as the ALJ summarized, “situational stressors that 

cause [Woods] distress,” such as Woods’s “fight[s] with 

[the] granddaughter” whom Woods was raising and 

Woods’s “mother’s health.” Although Bermeosolo checked 

a box on a letter to Woods’s attorney indicating that she 

concurred with Dr. Causeya’s psychological assessment, 

Bermeosolo’s concurring opinion is wholly unexplained and 

finding. Dr. Causeya supported her opinion with “relevant . . . objective 

medical evidence and supporting explanations,” 20 C.F.R. 

§ 404.1520c(c)(1), and the ALJ did not suggest otherwise. Rather, the 

ALJ meant only that Dr. Causeya’s opinion was inconsistent with other 

record evidence. Although the ALJ’s meaning here is clear from context, 

to avoid confusion in future cases, ALJs should endeavor to use these 

two terms of art—“consistent” and “supported”—with precision.
WOODS V. KIJAKAZI 17

thus unsupported. The ALJ reasonably rejected it. See Ford, 

950 F.3d at 1155.

IV.

Woods also contends that the ALJ failed to consider all 

her physical and mental limitations that are supported by the 

record. In assessing Woods’s residual functional capacity, 

the ALJ was required to “consider all of [her known] 

medically determinable impairments . . . , including [those] 

that are not ‘severe.’” 20 C.F.R. § 404.1545(a)(2).

A.

The ALJ found that Woods can perform “light work” 

with frequent balancing, stooping, crouching, crawling, and 

reaching overhead, but only occasional climbing. In general, 

light work “requires a good deal of walking or standing” and 

“frequent lifting or carrying of objects weighing up to 

10 pounds” but “no more than 20 pounds at a time.” 

20 C.F.R. § 404.1567(b).

Woods asserts that the ALJ “[did] not consider the 

evidence that prolonged standing exacerbates the pain and 

swelling in [her] legs and feet.” To the contrary, the ALJ 

acknowledged her testimony that “if she works too much one 

day, she is down for . . . 3 or 4 days” as well as her statement 

to a family nurse practitioner that she “had to space . . . out” 

her three daily clients. The ALJ reasonably discounted 

Woods’s “statements concerning the intensity, persistence 

and limiting effects” of her pain and swelling as “not entirely 

consistent with the medical evidence and other evidence in 

the record.”

Nor did the ALJ limit his consideration, as Woods 

suggests, to her own subjective statements about her 
18 WOODS V. KIJAKAZI

physical impairments. For example, the ALJ addressed the 

opinion of Certified Nurse Practitioner Lindsay McGinnis 

that Woods should not stand or walk for more than four 

hours in a workday and needs to sit for 30 minutes every two 

hours. McGinnis expressed these limitations on a fill-in-theblank questionnaire from Woods’s attorney. The ALJ found 

McGinnis’s opinion “not persuasive because it is not 

supported by any explanation” or “pertinent exam findings.”

The ALJ also found McGinnis’s opinion “inconsistent 

with the objective treating record, exam findings and 

imaging,” as well as Woods’s “work activities combined 

with her parenting and other activities.” In particular, the 

ALJ cited the “fairly benign” results of an MRI examining 

Woods’s cervical spine and the “very conservative[]” 

treatment of her symptoms—“mostly with medication alone 

until she received a left knee injection in December of 

2018.” Substantial record evidence supports these findings.

B.

Woods faults the ALJ for including no mental limitations 

in her residual functional capacity because, she asserts, her 

psycho-diagnostic evaluation and two years of mental health 

treatment records document problems with mood, anxiety, 

memory, and concentration. The ALJ was required to 

“assess the nature and extent of [her] mental limitations and 

restrictions” and whether they “reduce [her] ability to do past 

work and other work.” 20 C.F.R. § 404.1545(c).

The ALJ considered Woods’s mental health records and 

assessed her mental functioning in four broad areas known 

as the “paragraph B” criteria. See 20 C.F.R. pt. 404, subpt. 

P, app. 1 § 12.00.A.2.b. The ALJ found that Woods had 

“mild limitation[s]” in two of the criteria—“understanding, 

remembering, or applying information” and “concentrating, 
WOODS V. KIJAKAZI 19

persisting, or maintaining pace.” The ALJ found that Woods 

had “no limitation[s]” in the other two paragraph B 

criteria—“interacting with others” and “adapting or 

managing oneself.” The ALJ’s assessment of her residual 

functional capacity expressly reflected these limitations.

Woods does not identify any particular evidence that the 

ALJ failed to consider or explain why the record does not 

support the ALJ’s findings regarding her mental functioning. 

The ALJ considered and reasonably rejected the more severe 

limitations prescribed by Dr. Causeya. As for Woods’s 

remaining treatment record, the ALJ characterized it as “not 

reflect[ing] any significant complaints of mental health 

symptoms.” This characterization is well supported by the 

record.

AFFIRMED.